Provider Demographics
NPI:1639067275
Name:GRAY, PATSY N
Entity type:Individual
Prefix:
First Name:PATSY
Middle Name:N
Last Name:GRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8245 SWIFT RD NW
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44688-9603
Mailing Address - Country:US
Mailing Address - Phone:330-371-9211
Mailing Address - Fax:330-371-9211
Practice Address - Street 1:8245 SWIFT RD NW
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:OH
Practice Address - Zip Code:44688-9603
Practice Address - Country:US
Practice Address - Phone:330-371-9211
Practice Address - Fax:330-371-9211
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5361550253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care